Resilient and responsive health systems in a changing world
Guest Editors: Siri Wiig and Jane O'Hara
The world is amidst one of its greatest public health challenges due to the tragic impact of the global COVID-19 pandemic. We have witnessed the extreme strains on health systems but also their resilience and responsiveness to the pressures they have faced. We must also recognize that it is not only COVID-19 that has put a strain on health systems. Other infectious diseases, economic pressures, environmental disasters, staff shortages, and chronic diseases are amongst the many other challenges health systems are facing.
In support of the challenges that global health systems are facing and UN Sustainable Development Goal 3, Good Health and Well-being, BMC Health Services Research has launched a collection that welcomes submissions that contribute to our understanding of how health systems respond and resist the pressures they face, and how we can sustainably strengthen health systems for the future.
For more information about the scope of the collection, please read our introductory commentary article written by our Guest Editors.

Prof. Siri Wiig, University of Stavanger, Norway
Siri Wiig, PhD, MSc, is Professor and Centre Director at SHARE - Centre for Resilience in Healthcare, at the University of Stavanger (UiS), Norway. The SHARE centre is a large research group in Norway doing research on quality and safety in healthcare, with over 70 researchers affiliated. Wiig is a full Professor of Quality and Safety in Healthcare Systems at the Faculty of Health Sciences, UiS. Key research interests are resilience in healthcare, patient safety, quality improvement, safety investigations, user involvement, risk regulation, leadership, and learning in socio-technical systems.
Prof. Jane K. O'Hara, University of Leeds, UK
Jane K. O'Hara is a Professor of Healthcare Quality & Safety, based at the University of Leeds, and Deputy Director of the Yorkshire Quality & Safety Research Group. Her research interests include resilient healthcare, exploring and operationalizing safety theories, safety measurement and management, and patient and family involvement in patient safety.
This collection welcomes submissions of Research articles, including systematic reviews, quantitative, qualitative, and mixed-methods research on the topic of resilience and responsiveness in all areas of the health system. Reviews, Study Protocols, and Comments will be considered at the discretion of the Journal’s Editor. Please note that unsolicited Reviews and Comments will not be considered, as per our submission guidelines.
Articles will undergo the journal’s standard peer-review process overseen by our Guest Editors, Prof. Siri Wiig (University of Stavanger, Norway) and Prof. Jane O’Hara (University of Leeds, UK). Articles will be added to the Collection as they are published.
Before submitting your manuscript, please ensure you have carefully read the submission guidelines for BMC Health Services Research. Please ensure you highlight in your cover letter that you are submitting to a collection. Articles for this Collection should be submitted via our submission system, Snapp. During the submission process you will be asked whether you are submitting to a Collection, please select "Resilient and responsive health systems in a changing world" from the dropdown menu".
Please visit this page to find out more about our article-processing charges. Members of Health Systems Global can claim a 20% discount on our article-processing charges, more information can be found here.
Articles submitted after 31st January 2023 will not be eligible for inclusion in the collection.
Published collection articles
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Although slack is an asset to resilient hospitals, it is usually explicitly discussed only in terms of the quantity and quality of beds and staff. This paper expands this view by addressing slack in four infra...
Authors:
Carlos Emilio Stigler Marczyk, Tarcisio Abreu Saurin, Iamara Rossi Bulhões, Riccardo Patriarca and Federico Bilotta
Citation:
BMC Health Services Research
2023
23:579
Content type: Research
Published on: 6 June 2023
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Sub-Saharan Africa is experiencing a dual burden of chronic human immunodeficiency virus and non-communicable diseases. A pragmatic parallel arm cluster randomised trial (INTE-AFRICA) scaled up ‘one-stop’ integra...
Authors:
Marie Claire Van Hout, Flavia Zalwango, Mathias Akugizibwe, Moreen Namulundu Chaka, Josephine Birungi, Joseph Okebe, Shabbar Jaffar, Max Bachmann and Jamie Murdoch
Citation:
BMC Health Services Research
2023
23:570
Content type: Research
Published on: 2 June 2023
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Accordons-nous, a smartphone app, was developed to support patients in the advance care planning (ACP) process. The app raises awareness and facilitates communication on this sensitive topic. It helps patients ex...
Authors:
Céline Schöpfer, Catherine Bollondi, Mohamed Amir Moussa, Johanna Sommer and Christine Clavien
Citation:
BMC Health Services Research
2023
23:566
Content type: Research
Published on: 1 June 2023
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The COVID-19 pandemic had a major impact on healthcare systems around the world, and lack of resources, lack of adequate preparedness and infection control equipment have been highlighted as common challenges....
Authors:
Camilla Seljemo, Siri Wiig, Olav Røise and Eline Ree
Citation:
BMC Health Services Research
2023
23:492
Content type: Research
Published on: 16 May 2023
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Health systems aim to provide a range of services to meet the growing demand of Dubai's heathcare system aims to provide a range of services to meet the growing demand of its population health needs and to ens...
Authors:
Nahed Monsef, Eldaw Suliman, Elham Ashkar and Hamid Yahay Hussain
Citation:
BMC Health Services Research
2023
23:468
Content type: Research
Published on: 10 May 2023
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Elderly patients with chronic diseases are very vulnerable during the transition from hospital to home and have a high need for transitional care. The quality of transitional care is closely related to patient...
Authors:
La-mei Liu, Meng-jie Sun, Meng-ting Liu, Jia-nan Wang, Yi-zhen Zhang and Ronnell D Dela Rosa
Citation:
BMC Health Services Research
2023
23:460
Content type: Research
Published on: 9 May 2023
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Complex health interventions involve deep organizational, structural, and cultural changes that challenge health teams and decision-makers. The explosion of chronic diseases has made the multimorbidity approac...
Authors:
Teresita Varela, Paula Zamorano, Paulina Muñoz, Carolina Rain, Esteban Irazoqui, Jaime C. Sapag and Alvaro Tellez
Citation:
BMC Health Services Research
2023
23:439
Content type: Research
Published on: 4 May 2023
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The coronavirus pandemic has had a profound impact on organization and delivery of care. The challenges faced by healthcare organizations in dealing with the pandemic have intensified interest in the concept o...
Authors:
Agnieszka Ignatowicz, Carolyn Tarrant, Russell Mannion, Dena El-Sawy, Simon Conroy and Daniel Lasserson
Citation:
BMC Health Services Research
2023
23:376
Content type: Research
Published on: 19 April 2023
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As health systems struggle to tackle the spread of Covid-19, resilience becomes an especially relevant attribute and research topic. More than strength or preparedness, to perform resiliently to emerging shock...
Authors:
Paulo Victor Rodrigues de Carvalho, Hugo Bellas, Jaqueline Viana, Paula de Castro Nunes, Rodrigo Arcuri, Valéria da Silva Fonseca, Ana Paula Morgado Carneiro and Alessandro Jatobá
Citation:
BMC Health Services Research
2023
23:349
Content type: Research
Published on: 10 April 2023
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Disruptions to healthcare services during the COVID-19 pandemic are well-recognised problems. However, a dearth of research exists on disabled people’s experiences with accessing these services. A scoping revi...
Authors:
Karen McBride-Henry, Solmaz Nazari Orakani, Gretchen Good, Michael Roguski and Tara N. Officer
Citation:
BMC Health Services Research
2023
23:346
Content type: Research
Published on: 6 April 2023
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Workflow interruptions in pharmacies contribute to dispensing errors, a high-priority issue in patient safety, but have rarely been studied from a systemic perspective partly because of the limitations of the ...
Authors:
Takahiro Kojima, Noriyasu Kinoshita, Harumi Kitamura, Koji Tanaka, Ayumi Tokunaga, Satoshi Nakagawa, Takeru Abe and Kazue Nakajima
Citation:
BMC Health Services Research
2023
23:331
Content type: Research
Published on: 3 April 2023
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Resilient healthcare organizations maintain critical functions and high-quality care under varying conditions. While previous research has focused on the activities of frontline healthcare professionals workin...
Authors:
Ingrid Svensson, Mia von Knorring, Heidi Hagerman, Cecilia Fagerström, Mirjam Ekstedt and Lisa Smeds Alenius
Citation:
BMC Health Services Research
2023
23:321
Content type: Research article
Published on: 31 March 2023
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COVID-19 has caused significant public health problems globally, with catastrophic impacts on health systems. This study explored the adaptations to health services in Liberia and Merseyside UK at the beginnin...
Authors:
Yussif Alhassan, Zeela Zaizay, Laura Dean, Rosalind McCollum, Victoria Watson, Karsor Kollie, Helen Piotrowski, Olivia Hastie, Colleen Parker, Russell Dacombe, Sally Theobald and Miriam Taegtmeyer
Citation:
BMC Health Services Research
2023
23:304
Content type: Research
Published on: 29 March 2023
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Resilience is often referred to when assessing the ability of health systems to maintain their functions during unexpected events. Primary healthcare forms the basis for the health system and thus its resilien...
Authors:
Soila Karreinen, Henna Paananen, Laura Kihlström, Kristiina Janhonen, Moona Huhtakangas, Marjaana Viita-aho and Liina-Kaisa Tynkkynen
Citation:
BMC Health Services Research
2023
23:233
Content type: Research article
Published on: 9 March 2023
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Health care facilities are responsible for preventing and controlling diseases and must be resilient enough to deal with crises. The Iranian health care facilities have faced challenges in managing COVID-19 pa...
Authors:
Farahnaz Ezzati, Ali Mohammad Mosadeghrad and Ebrahim Jaafaripooyan
Citation:
BMC Health Services Research
2023
23:207
Content type: Research
Published on: 1 March 2023
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In pandemics, it is critical to find a balance between healthcare demand, and capacity, taking into consideration the demands of the patients affected by the pandemic, as well as other patients (in elective or...
Authors:
Ritva Gisela Rosenbäck and Ann Svensson
Citation:
BMC Health Services Research
2023
23:202
Content type: Research
Published on: 28 February 2023
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BRAC (Bangladesh Rural Advancement Committee), the largest NGO globally, implemented a community-based comprehensive social behavior communication intervention to increase community resilience through preventi...
Authors:
Fahmida Akter, Malika Tamim, Avijit Saha, Imran Ahmed Chowdhury, Omor Faruque, Animesh Talukder, Mohiuddin Ahsanul Kabir Chowdhury, Monzur Morshed Patwary, Albaab-Ur Rahman, Morseda Chowdhury and Malabika Sarker
Citation:
BMC Health Services Research
2022
22:1590
Content type: Research article
Published on: 28 December 2022
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Discussions of health system resilience and emergency management often highlight the importance of coordination and partnership across government and with other stakeholders. However, both coordination and par...
Authors:
Kate Gooding, Maria Paola Bertone, Giulia Loffreda and Sophie Witter
Citation:
BMC Health Services Research
2022
22:1441
Content type: Research article
Published on: 29 November 2022
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Amidst ongoing calls for increased health systems resilience, gaps remain in our understanding of how health systems can reach further into communities to ensure resilient service delivery. Indeed, public heal...
Authors:
Victoria Haldane, Warren Dodd, Amy Kipp, Hannah Ferrolino, Kendall Wilson, Danilo Servano Jr., Lincoln L. Lau and Xiaolin Wei
Citation:
BMC Health Services Research
2022
22:1385
Content type: Research article
Published on: 21 November 2022
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The coronavirus disease 2019 (COVID-19) pandemic has had various impacts on businesses and workers worldwide. The spread of infection has been reported through cluster outbreaks in the workplace, and World Hea...
Authors:
Yu Igarashi, Seiichiro Tateishi, Tomoko Sawajima, Kodai Kikuchi, Mika Kawasumi, Juri Matsuoka, Arisa Harada and Koji Mori
Citation:
BMC Health Services Research
2022
22:1294
Content type: Research
Published on: 27 October 2022
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Research on health systems resilience has focused primarily on the theoretical development of the concept and its dimensions. There is an identified knowledge gap in the research on how to build resilience in ...
Authors:
Lena Forsgren, Fabrizio Tediosi, Karl Blanchet and Dell D Saulnier
Citation:
BMC Health Services Research
2022
22:1173
Content type: Research
Published on: 19 September 2022
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To provide high quality services in increasingly complex, constantly changing circumstances, healthcare organizations worldwide need a high level of resilience, to adapt and respond to challenges and changes a...
Authors:
Cecilie Haraldseid-Driftland, Stephen Billett, Veslemøy Guise, Lene Schibevaag, Janne Gro Alsvik, Birte Fagerdal, Hilda Bø Lyng and Siri Wiig
Citation:
BMC Health Services Research
2022
22:1091
Content type: Research article
Published on: 26 August 2022
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Hospitals are the biggest users of the health system budgets. Policymakers are interested in improving hospital efficiency while maintaining their performance during the economic crisis. This study aims at ana...
Authors:
Zeynab Foroughi, Parvin Ebrahimi, Aidin Aryankhesal, Mohammadreza Maleki and Shahram Yazdani
Citation:
BMC Health Services Research
2022
22:977
Content type: Research
Published on: 30 July 2022
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The prevailing patient safety strategies in suicide prevention are suicide risk assessments and retrospective reviews, with emphasis on minimising risk and preventing adverse events. Resilient healthcare focus...
Authors:
Siv Hilde Berg, Kristine Rørtveit, Fredrik A. Walby and Karina Aase
Citation:
BMC Health Services Research
2022
22:967
Content type: Research article
Published on: 29 July 2022
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Resilient healthcare research studies how healthcare systems and stakeholders adapt and cope with challenges and changes to enable high quality care. Team leaders are seen as central in coordinating clinical c...
Authors:
Birte Fagerdal, Hilda Bø Lyng, Veslemøy Guise, Janet E. Anderson, Petter Lave Thornam and Siri Wiig
Citation:
BMC Health Services Research
2022
22:908
Content type: Research
Published on: 13 July 2022
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The COVID-19 pandemic severely exacerbated workplace stress for healthcare workers (HCWs) worldwide. The pandemic also magnified the need for mechanisms to support the psychological wellbeing of HCWs. This stu...
Authors:
Benjamin Rosen, Mary Preisman, Heather Read, Deanna Chaukos, Rebecca A. Greenberg, Lianne Jeffs, Robert Maunder and Lesley Wiesenfeld
Citation:
BMC Health Services Research
2022
22:780
Content type: Research
Published on: 14 June 2022
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The COVID-19 pandemic has challenged healthcare organizations and puts focus on risk management in many ways. Both medical staff and leaders at various levels have been forced to find solutions to problems the...
Authors:
Maritha Jacobsson, Maria Härgestam, Fredrik Bååthe and Emma Hagqvist
Citation:
BMC Health Services Research
2022
22:738
Content type: Research
Published on: 3 June 2022
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The balanced scorecard (BSC) has been implemented to evaluate the performance of health care organizations (HCOs). BSC proved to be effective in improving financial performance and patient satisfaction.
Authors:
Faten Amer, Sahar Hammoud, Haitham Khatatbeh, Szimonetta Lohner, Imre Boncz and Dóra Endrei
Citation:
BMC Health Services Research
2022
22:621
Content type: Research
Published on: 9 May 2022
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The Quality Improvement Regulation was introduced to the Norwegian healthcare system in 2017 as a new national regulatory framework to support local quality and safety efforts in hospitals. A research-based respo...
Authors:
Sina Furnes Øyri and Siri Wiig
Citation:
BMC Health Services Research
2022
22:510
Content type: Research article
Published on: 15 April 2022
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Despite an emerging consensus on the importance of resilience as a framework for understanding the healthcare system, the operationalization of resilience in healthcare has become an area of continuous discuss...
Authors:
Hilda Bø Lyng, Carl Macrae, Veslemøy Guise, Cecilie Haraldseid-Driftland, Birte Fagerdal, Lene Schibevaag and Siri Wiig
Citation:
BMC Health Services Research
2022
22:474
Content type: Research
Published on: 10 April 2022
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Since climate change, pandemics and population mobility are challenging healthcare systems, an empirical and integrative research to studying and help improving the health systems resilience is needed. We pres...
Authors:
Lucie Clech, Sofia Meister, Maeva Belloiseau, Tarik Benmarhnia, Emmanuel Bonnet, Alain Casseus, Patrick Cloos, Christian Dagenais, Manuela De Allegri, Annabel Desgrées du Loû, Lucas Franceschin, Jean-Marc Goudet, Daniel Henrys, Dominique Mathon, Mowtushi Matin, Ludovic Queuille…
Citation:
BMC Health Services Research
2022
22:340
Content type: Study protocol
Published on: 15 March 2022
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Resilient and responsive healthcare systems is on the agenda as ever before. COVID-19, specialization of services, resource demands, and technology development are all examples of aspects leading to adaptation...
Authors:
Siri Wiig and Jane K. O’Hara
Citation:
BMC Health Services Research
2021
21:1037
Content type: Commentary
Published on: 4 October 2021
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The Covid-19 pandemic introduced a global crisis for the healthcare systems. Research has paid particular attention to hospitals and intensive care units. However, nursing homes and home care services in charg...
Authors:
Hilda Bø Lyng, Eline Ree, Torunn Wibe and Siri Wiig
Citation:
BMC Health Services Research
2021
21:878
Content type: Research
Published on: 27 August 2021
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Adaptation and innovation are both described as instrumental for resilience in healthcare. However, the relatedness between these dimensions of resilience in healthcare has not yet been studied. This study see...
Authors:
Hilda Bø Lyng, Carl Macrae, Veslemøy Guise, Cecilie Haraldseid-Driftland, Birte Fagerdal, Lene Schibevaag, Janne Gro Alsvik and Siri Wiig
Citation:
BMC Health Services Research
2021
21:759
Content type: Research
Published on: 31 July 2021